IDEAS home Printed from https://ideas.repec.org/a/eee/chieco/v22y2011i3p428-439.html
   My bibliography  Save this article

The productive efficiency of Chinese hospitals

Author

Listed:
  • Ng, Ying Chu

Abstract

Since the implementation of health care reforms, much has been documented regarding the practices and behavior of hospitals or health profession in China. While these documentations pointed to various problems arising from the reforms, a systematic analysis is rarely found. Based on five years' data, the present study aims at providing empirical evidence of inefficiency of hospitals in China. Using the data envelopment analysis, the sources of inefficiency were examined. Echoing the unnecessary care, over-prescription of drugs and the adoption of high-tech treatments since the implementation of health care reforms, the sampled hospitals were found quite inefficient and pure technical inefficiency played a dominant role in driving the inefficiency of hospitals. Combining the panel nature of the data and the Malmquist Index computation, hospitals had experienced productivity growth between 2004 and 2008. Mirroring the behavior of hospitals, technological progress was the underlying force for the growth and the deterioration in efficiency change was found. The results summarized by region revealed that the stage of economic development and the efficiency performance of hospital did not necessarily go hand in hand.

Suggested Citation

  • Ng, Ying Chu, 2011. "The productive efficiency of Chinese hospitals," China Economic Review, Elsevier, vol. 22(3), pages 428-439, September.
  • Handle: RePEc:eee:chieco:v:22:y:2011:i:3:p:428-439
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S1043951X11000460
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. David M. Cutler & Ernst R. Berndt, 2001. "Introduction to "Medical Care Output and Productivity"," NBER Chapters, in: Medical Care Output and Productivity, pages 1-12, National Bureau of Economic Research, Inc.
    2. Gary Ferrier & Michael Rosko & Vivian Valdmanis, 2006. "Analysis of uncompensated hospital care using a DEA model of output congestion," Health Care Management Science, Springer, vol. 9(2), pages 181-188, May.
    3. Anatoly I. Pilyavsky & William E. Aaronson & Patrick M. Bernet & Michael D. Rosko & Vivian G. Valdmanis & Mikhail V. Golubchikov, 2006. "East–west: does it make a difference to hospital efficiencies in Ukraine?," Health Economics, John Wiley & Sons, Ltd., vol. 15(11), pages 1173-1186, November.
    4. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
    5. Eggleston, Karen & Wang, Jian & Rao, Keqin, 2008. "From plan to market in the health sector?: China's experience," Journal of Asian Economics, Elsevier, vol. 19(5-6), pages 400-412.
    6. Dino Rizzi & Vincenzo Rebba, 2006. "Measuring Hospital Efficiency through Data Envelopment Analysis when Policy-makers� Preferences Matter. An Application to a sample of Italian NHS hospitals," Working Papers 2006_13, Department of Economics, University of Venice "Ca' Foscari".
    7. Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
    8. Karen Eggleston & Winnie Yip, 2004. "Hospital Competition under Regulated Prices: Application to Urban Health Sector Reforms in China," International Journal of Health Economics and Management, Springer, vol. 4(4), pages 343-368, December.
    9. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    10. Liu, Xingzhu & Mills, Anne, 2002. "Financing reforms of public health services in China: lessons for other nations," Social Science & Medicine, Elsevier, vol. 54(11), pages 1691-1698, June.
    11. Karen Eggleston & Li Ling & Meng Qingyue & Magnus Lindelow & Adam Wagstaff, 2008. "Health service delivery in China: a literature review," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 149-165, February.
    12. Caves, Douglas W & Christensen, Laurits R & Diewert, W Erwin, 1982. "The Economic Theory of Index Numbers and the Measurement of Input, Output, and Productivity," Econometrica, Econometric Society, vol. 50(6), pages 1393-1414, November.
    13. Nikolaos Maniadakis & Emmanuel Thanassoulis, 2000. "Assessing productivity changes in UK hospitals reflecting technology and input prices," Applied Economics, Taylor & Francis Journals, vol. 32(12), pages 1575-1589.
    14. Chang, Hsihui & Cheng, Mei-Ai & Das, Somnath, 2004. "Hospital ownership and operating efficiency: Evidence from Taiwan," European Journal of Operational Research, Elsevier, vol. 159(2), pages 513-527, December.
    15. Gian Paolo Barbetta & Gilberto Turati & Angelo M. Zago, 2007. "Behavioral differences between public and private not‐for‐profit hospitals in the Italian national health service," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 75-96, January.
    16. Meng, Qingyue & Rehnberg, Clas & Zhuang, Ning & Bian, Ying & Tomson, Goran & Tang, Shenglan, 2004. "The impact of urban health insurance reform on hospital charges: a case study from two cities in China," Health Policy, Elsevier, vol. 68(2), pages 197-209, May.
    17. H. Brown & José Pagán, 2006. "Managed care and the scale efficiency of US hospitals," International Journal of Health Economics and Management, Springer, vol. 6(4), pages 278-289, December.
    18. Anatoly Pilyavsky & Matthias Staat, 2006. "Health care in the CIS countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(3), pages 185-191, September.
    19. E Zere & Diane Mcintyre & T Addison, 2001. "Technical Efficiency And Productivity Of Public Sector Hospitals In Three South African Provinces," South African Journal of Economics, Economic Society of South Africa, vol. 69(2), pages 336-358, June.
    20. Chen, Andrew & Hwang, Yuhchang & Shao, Benjamin, 2005. "Measurement and sources of overall and input inefficiencies: Evidences and implications in hospital services," European Journal of Operational Research, Elsevier, vol. 161(2), pages 447-468, March.
    21. Richard Herd & Yu-Wei Hu & Vincent Koen, 2010. "Improving China's Health Care System," OECD Economics Department Working Papers 751, OECD Publishing.
    22. Fare, Rolf & Grosskopf, Shawna & Yaisawarng, Suthathip & Li, Sung Ko & Wang, Zhaoping, 1990. "Productivity growth in Illinois electric utilities," Resources and Energy, Elsevier, vol. 12(4), pages 383-398, December.
    23. Margit Sommersguter-Reichmann, 2000. "The impact of the Austrian hospital financing reform on hospital productivity: empirical evidence on efficiency and technology changes using a non-parametric input-based Malmquist approach," Health Care Management Science, Springer, vol. 3(4), pages 309-321, September.
    24. David M. Cutler & Ernst R. Berndt, 2001. "Medical Care Output and Productivity," NBER Books, National Bureau of Economic Research, Inc, number cutl01-1.
    25. Jens Leth Hougaard & Lars Peter Østerdal & Yi Yu, 2008. "The Chinese Health Care System: Structure, Problems and Challenges," Discussion Papers 08-01, University of Copenhagen. Department of Economics.
    26. L. Steinmann & P. Zweifel, 2003. "On the (in)efficiency of Swiss hospitals," Applied Economics, Taylor & Francis Journals, vol. 35(3), pages 361-370.
    27. Lukas Steinmann & Gunnar Dittrich & Alexander Karmann & Peter Zweifel, 2004. "Measuring and comparing the (in)efficiency of German and Swiss hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(3), pages 216-226, September.
    28. Brenda Gannon, 2005. "Testing for Variation in Technical Efficiency of Hospitals in Ireland," The Economic and Social Review, Economic and Social Studies, vol. 36(3), pages 273-294.
    29. Emrouznejad, Ali & Parker, Barnett R. & Tavares, Gabriel, 2008. "Evaluation of research in efficiency and productivity: A survey and analysis of the first 30 years of scholarly literature in DEA," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 151-157, September.
    30. Matthias Staat, 2006. "Efficiency of hospitals in Germany: a DEA-bootstrap approach," Applied Economics, Taylor & Francis Journals, vol. 38(19), pages 2255-2263.
    31. Rolf Färe & Shawna Grosskopf & William L. Weber, 1989. "Measuring School District Performance," Public Finance Review, , vol. 17(4), pages 409-428, October.
    32. Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 7-23, July.
    33. Gillian McCallion & J. Colin Glass & Robert Jackson & Christine Kerr & Donal McKillop, 2000. "Investigating productivity change and hospital size: a nonparametric frontier approach," Applied Economics, Taylor & Francis Journals, vol. 32(2), pages 161-174.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Dinesh R. Pai & Fatma Pakdil & Nasibeh Azadeh-Fard, 2024. "Applications of data envelopment analysis in acute care hospitals: a systematic literature review, 1984–2022," Health Care Management Science, Springer, vol. 27(2), pages 284-312, June.
    2. Hu, Hsin-Hui & Qi, Qinghui & Yang, Chih-Hai, 2012. "Analysis of hospital technical efficiency in China: Effect of health insurance reform," China Economic Review, Elsevier, vol. 23(4), pages 865-877.
    3. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2019. "The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 22(2), pages 245-286, June.
    4. Thomas Czypionka & Markus Kraus & Susanne Mayer & Gerald Röhrling, 2014. "Efficiency, ownership, and financing of hospitals: The case of Austria," Health Care Management Science, Springer, vol. 17(4), pages 331-347, December.
    5. Mansour Abdullah Almiman, 2021. "Measuring the Efficiency of Public Hospitals in Saudi Arabia Using the Data Envelopment Analysis Approach," International Journal of Business and Management, Canadian Center of Science and Education, vol. 13(12), pages 111-111, July.
    6. repec:rre:publsh:v:38:y:2008:i:3:p:381-93 is not listed on IDEAS
    7. José M. Cordero & Agustín García-García & Enrique Lau-Cortés & Cristina Polo, 2021. "Efficiency and Productivity Change of Public Hospitals in Panama: Do Management Schemes Matter?," IJERPH, MDPI, vol. 18(16), pages 1-21, August.
    8. Antonio José Orozco-Gallo, 2017. "Una aproximación regional a la eficiencia y productividad de los hospitales públicos colombianos," Chapters, in: Jaime Bonet & Karelys Guzmán-Finol & Lucas Wilfried Hahn-De-Castro (ed.), La salud en Colombia: una perspectiva regional, chapter 6, pages 173-209, Banco de la Republica de Colombia.
    9. Greta Falavigna & Roberto Ippoliti & Alessandro Manello, 2013. "Hospital organization and performance: a directional distance function approach," Health Care Management Science, Springer, vol. 16(2), pages 139-151, June.
    10. Fengyi Lin & Yung-Jr Deng & Wen-Min Lu & Qian Long Kweh, 2019. "Impulse response function analysis of the impacts of hospital accreditations on hospital efficiency," Health Care Management Science, Springer, vol. 22(3), pages 394-409, September.
    11. Ismet Sahin & Yasar Ozcan & Hacer Ozgen, 2011. "Assessment of hospital efficiency under health transformation program in Turkey," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 19(1), pages 19-37, March.
    12. Nurhafiza Md Hamzah & Kok Fong See, 2019. "Technical efficiency and its influencing factors in Malaysian hospital pharmacy services," Health Care Management Science, Springer, vol. 22(3), pages 462-474, September.
    13. George Fragkiadakis & Michael Doumpos & Constantin Zopounidis & Christophe Germain, 2016. "Operational and economic efficiency analysis of public hospitals in Greece," Post-Print hal-01414677, HAL.
    14. Martine Audibert & Xiao Xian Huang & Jacky Mathonnat & Aurore Pelissier & Anning Ma, 2012. "Health Insurance Reform and Efficiency of Township Hospitals in Rural China: An Analysis from Survey Data," CERDI Working papers halshs-00587799, HAL.
    15. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
    16. See, Kok Fong & Ng, Ying Chu, 2021. "Do hospital reform and ownership matter to Shenzhen hospitals in China? A productivity analysis," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 145-155.
    17. Audibert, Martine & Mathonnat, Jacky & Pelissier, Aurore & Huang, Xiao Xian & Ma, Anning, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," China Economic Review, Elsevier, vol. 27(C), pages 326-338.
    18. Lorena Androutsou & Michail Kokkinos & Dimitra Latsou & Mary Geitona, 2022. "Assessing the Efficiency and Productivity of the Hospital Clinics on the Island of Rhodes during the COVID-19 Pandemic," IJERPH, MDPI, vol. 19(23), pages 1-12, November.
    19. Bao Hoang Nguyen & Robin C. Sickles & Valentin Zelenyuk, 2021. "What do we know from the vast literature on efficiency and productivity in healthcare? A Systematic Review and Bibliometric Analysis," CEPA Working Papers Series WP092021, School of Economics, University of Queensland, Australia.
    20. George Fragkiadakis & Michael Doumpos & Constantin Zopounidis & Christophe Germain, 2016. "Operational and economic efficiency analysis of public hospitals in Greece," Annals of Operations Research, Springer, vol. 247(2), pages 787-806, December.
    21. Yang, Jinqiu & Zeng, Wu, 2014. "The trade-offs between efficiency and quality in the hospital production: Some evidence from Shenzhen, China," China Economic Review, Elsevier, vol. 31(C), pages 166-184.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:chieco:v:22:y:2011:i:3:p:428-439. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/chieco .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.